扩大循证实践规模的能力建设跨部门协作团队模式。
Interagency Collaborative Team Model for Capacity Building to Scale-Up Evidence-Based Practice.
作者信息
Hurlburt Michael, Aarons Gregory A, Fettes Danielle, Willging Cathleen, Gunderson Lara, Chaffin Mark J
机构信息
School of Social Work, University of Southern California, Los Angeles, CA; Child and Adolescent Services Research Center.
Child and Adolescent Services Research Center; Department of Psychiatry, University of California, San Diego, La Jolla, CA.
出版信息
Child Youth Serv Rev. 2014 Apr;39:160-168. doi: 10.1016/j.childyouth.2013.10.005.
BACKGROUND
System-wide scale up of evidence-based practice (EBP) is a complex process. Yet, few strategic approaches exist to support EBP implementation and sustainment across a service system. Building on the Exploration, Preparation, Implementation, and Sustainment (EPIS) implementation framework, we developed and are testing the Interagency Collaborative Team (ICT) process model to implement an evidence-based child neglect intervention (i.e., SafeCare®) within a large children's service system. The ICT model emphasizes the role of local agency collaborations in creating structural supports for successful implementation.
METHODS
We describe the ICT model and present preliminary qualitative results from use of the implementation model in one large scale EBP implementation. Qualitative interviews were conducted to assess challenges in building system, organization, and home visitor collaboration and capacity to implement the EBP. Data collection and analysis centered on EBP implementation issues, as well as the experiences of home visitors under the ICT model.
RESULTS
Six notable issues relating to implementation process emerged from participant interviews, including: (a) initial commitment and collaboration among stakeholders, (b) leadership, (c) communication, (d) practice fit with local context, (e) ongoing negotiation and problem solving, and (f) early successes. These issues highlight strengths and areas for development in the ICT model.
CONCLUSIONS
Use of the ICT model led to sustained and widespread use of SafeCare in one large county. Although some aspects of the implementation model may benefit from enhancement, qualitative findings suggest that the ICT process generates strong structural supports for implementation and creates conditions in which tensions between EBP structure and local contextual variations can be resolved in ways that support the expansion and maintenance of an EBP while preserving potential for public health benefit.
背景
在全系统范围内扩大循证实践（EBP）是一个复杂的过程。然而，几乎没有战略方法来支持在服务系统中实施和维持循证实践。基于探索、准备、实施和维持（EPIS）实施框架，我们开发并正在测试跨部门协作团队（ICT）流程模型，以便在一个大型儿童服务系统中实施一项基于证据的儿童忽视干预措施（即SafeCare®）。ICT模型强调地方机构合作在为成功实施创造结构性支持方面的作用。
方法
我们描述了ICT模型，并展示了在一次大规模循证实践实施中使用该实施模型的初步定性结果。进行了定性访谈，以评估在建立系统、组织和家访者协作以及实施循证实践的能力方面所面临的挑战。数据收集和分析围绕循证实践实施问题以及ICT模型下家访者的经验展开。
结果
参与者访谈中出现了六个与实施过程相关的显著问题，包括：（a）利益相关者的初步承诺与协作；（b）领导力；（c）沟通；（d）实践与当地情况的契合度；（e）持续的协商与问题解决；（f）早期成功。这些问题突出了ICT模型的优势和有待发展的领域。
结论
在一个大县中，ICT模型的使用使得SafeCare得到了持续且广泛的应用。尽管实施模型的某些方面可能需要改进，但定性研究结果表明，ICT流程为实施提供了强大的结构性支持，并创造了条件，使得在支持循证实践的扩展和维持同时保留公共卫生效益潜力的情况下，能够解决循证实践结构与当地情况差异之间的矛盾。
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